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Vol. 7. Núm. 1.
Páginas 11-17 (enero 1996)
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Vol. 7. Núm. 1.
Páginas 11-17 (enero 1996)
Maxilotomía ampliada (LeFort I con segmentación sagital) como vía de abordaje a la base craneal
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G. Sánchez Aniceto, A. Silván González de Rivera, J.C. Moreno Vázquez, R. Díez Lobato, A. Cabrera Yesares, V. López Pizarra, R. Castillo Escandón
Servicios de Cirugía Maxilofacial y Neurocirugía. Hospital Universitario 12 de Octubre
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Resumen

Se describe el abordaje mediante maxilotomía ampliada LeFort I con segmentación sagital del compartimento central de la base del cráneo. En cinco pacientes se utilizó para la resección de tumores del clivus, y en otro para la descompresión de la unión bulbomedular en una malformación de la charnela occipitovertebral. En los seis casos el campo quirúrgico fue óptimo, ningún paciente presentó secuelas estéticas ni funcionales relacionadas con la técnica de abordaje. De los seis pacientes, uno falleció en el postoperatorio tardío a causa de una hemorragia masiva proveniente de un tumor maligno de clivus resecado subtotalmente, no mostrando en ningún momento su maxilar superior signos de compromiso vascular. El tiempo medio de abordaje con esta técnica fue de unos noventa minutos, y de otros noventa para la reconstrucción, una vez finalizado el tiempo neuroquirúrgico.

Palabras Clave:
Maxilotomía ampliada
Abordaje transfacial
Abordaje transclival
Tumor
Base craneal
Summary

The authors describe the surgical approach to the central compartment of the skull base by means of an extended maxillotomy -LeFort I osteotomy with midpalatal split. Five patients underwent clival tumor resection, and one a bulbomedullar junction decompression because an occipitovertebral malformation. Surgical exposure obtained with this approach was excelent in all cases, and there were no aesthetic or functional sequels related to the approach itself. One patient died in the late postoperative course because of a local bleeding arising from a subtotally resected clival malignant tumor. The mean surgical time for the approach was ninety minutes, and we spent ninety minutes more for the reconstruction following the neurosurgical intervention.

Key Words:
Extended maxillotomy
Transfacial approach
Transclival approach
Tumor
Cranial base

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